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We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.
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Humans , Female , Palliative Care , Quality of Life , Head and Neck Neoplasms/therapyABSTRACT
End-stage patients experience unbearable pain because of refractory symptoms.Palliative sedation is a form of palliative care which relieves patients' agony by lowering their consciousness.Standard palliative sedation can help patients die with dignity.It is distinct from euthanasia and does not alter the survival of patients.Sufficient palliative care is the premise of palliative sedation.Repeated and detailed clinical evaluation,as well as multidisciplinary involvement,is necessary for the standardized implementation of palliative sedation.Here,we proposed the standard process and specifications of palliative sedation in Peking Union Medical College Hospital.Furthermore,we reported a case of palliative sedation for an advanced cancer patient with refractory delirium and living pain to demonstrate its application in clinical practice.
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Humans , Anesthesia , Pain , Hospitals , Palliative Care , UniversitiesABSTRACT
AIM: To observe the characteristics of microperimetry in patients with glaucoma, and investigate the correlation between microperimetry and best corrected visual acuity(BCVA), standard automatic perimetry and optical coherence tomography(OCT)index.METHODS: This case-control study included 45 patients(76 eyes)with glaucoma(glaucoma group), among which 15 patients(25 eyes)with primary open-angle glaucoma and 30 patients(51 eyes)with chronic angle-closure glaucoma, and 40 healthy individuals(76 eyes)were included in the control group. MAIA microperimetry, Humphrey perimetry, and BCVA tests were performed in all examined eyes. Correlation analysis was performed using the structural indices measured by OCT.RESULTS: The mean sensitivity(MS)in macular area measured by microperimetry and the ganglion cell complex(GCC)and retinal nerve fiber layer(RNFL)thickness measured by OCT were decreased in glaucoma patients when compared to the control group. Additionally, the mean defect(MD)measured by Humphrey perimetry(10-2 visual field test), focal loss volume(FLV), global loss volume(GLV)measured by OCT, and 63% bivariate contour ellipse area(BCEA )measured by MAIA microperimetry were higher than those of the control group. The MS was negatively correlated with MD, FLV, GLV and BCVA(LogMAR)in the glaucoma group(rs=-0.839, -0.665, -0.530, and -0.424, all P<0.01). In contrast, MS was positively correlated with GCC and RNFL in the glaucoma group(rs=0.437, 0.500, all P<0.01). MAIA microperimetry had a shorter detection time. Receiver operating characteristic(ROC)curve analysis showed that MAIA microperimetry had moderate accuracy for the diagnosis of glaucoma.CONCLUSIONS: MAIA microperimetry has high sensitivity and can detect retinal sensitivity reduction in areas of structural damage tested by OCT. The microperimetry values were correlated with BCVA, standard automatic perimetry parameters, and OCT parameters. MAIA microperimetry combined with OCT will increase the early diagnosis rate of glaucoma.
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Background and Objectives@#There still are controversies on which type between bovine pericardial and porcine valves is superior in the setting of aortic valve replacement (AVR). This study aims to compare clinical outcomes of AVR using between pericardial or porcine valves. @*Methods@#The study involved consecutive 636 patients underwent isolated AVR using stented bioprosthetic valves between January 2000 and May 2016. Of these, pericardial and porcine valves were implanted in 410 (pericardial group) and 226 patients (porcine group), respectively. Clinical outcomes including survival, structural valve deterioration (SVD) and trans-valvular pressure gradient were compared between the groups. To adjust for potential selection bias, inverse probability treatment weighting (IPTW) was conducted. @*Results@#The mean follow-up duration was 60.1±50.2 months. There were no significant differences in the rates of early mortality (3.1% vs. 3.1%; p=0.81) and SVD (0.3%/patient-year [PY] vs. 0.5%/PY; p=0.33) between groups. After adjustment using IPTW, however, landmark mortality analyses showed a significantly lower late (>8 years) mortality risk in pericardial group over porcine group (hazard ratio [HR], 0.61; 95% confidence interval, [CI] 0.41–0.90; p=0.01) while the risks of SVD were not significantly difference between groups (HR, 0.45; 95% CI, 0.12–1.70; p=0.24). Mean pressure gradient across prosthetic AV was lower in the Pericardial group than the Porcine group at both immediate postoperative point and latest follow-up (p values <0.001). @*Conclusions@#In patients undergoing bioprosthetic surgical AVR, bovine pericardial valves showed superior results in terms of postoperative hemodynamic profiles and late survival rates over porcine valves.
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Background and Objectives@#To investigate the diagnostic validity of auditory brainstem response (ABR) in the screening of vestibular schwannoma (VS). @*Subjects and Methods@#Forty patients diagnosed with VS using magnetic resonance imaging who had undergone ABR before treatment between 2005 and 2015 were included. ABR results were considered positive when findings met at least one of the following criteria: 1) absent evoked response, 2) desynchronization of waves other than wave I, 3) interpeak latency (IPL) between waves I and III >2.5 ms, 4) IPL between waves I and V >4.4 ms, 5) wave V interaural latency difference >0.2 ms, and 6) interaural difference in IPL between waves I and V >0.2 ms. @*Results@#The overall sensitivity of ABR was 85.0%. For tumors measuring 10 mm. The sensitivity of tumors confined to the internal acoustic canal was 73.3% compared with 100.0% for tumors confined to the cerebellopontine angle. In patients with serviceable hearing, the mean tumor size was 7.8±2.9 mm in patients with a normal ABR and 15.1±9.4 mm in patients with an abnormal ABR, indicating a significant difference (p10 mm in patients with serviceable hearing, supporting the need for further active diagnostic and treatment modalities in clinical practice.
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Background@#Recently developed imaging techniques, such as cone beam computed tomography (CBCT) and CAD/CAM technology, have facilitated reliable implant planning and implant surgical guide production by 3D printing. This study compared the accuracy of implant-guided surgery using the R2GATE® program with CBCT before and after surgery. @*Patients and methods@#The study included patients who visited the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital from September 2021 to March 2022. Twenty-four implants were placed in eleven patients. Using R2GATE® Windows (Megagen implant, Daegu, Korea) software, implant placement was planned. The difference was measured by the CBCT before and after surgery. The cervical and apical distance and angular deviation of the implants were measured. Statistical analysis was performed using an independent t-test, Pearson correlation, and multiple regression analyses. @*Results@#The three-dimensional linear distance difference between the planned implant and the placed implant was 0.97 ± 0.37 mm at the cervical and 1.13 ± 0.36 mm at the apical. The difference in angle deviation between the planned implant and the placed implant was 3.42 ± 2.12°. Among the variables affecting the accuracy of implant placement, a statistically significant difference was found when using a tissue-supported implant guide, implant diameter and implant length. @*Conclusion@#Based on these results, using the R2GATE® program is useful to use an implant digital surgical guide, and it will be used in various clinic.
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Intralabyrinthine schwannomas are rare benign tumors, which arise from neural portions within the labyrinth. These are subclassified into seven groups according to the affected inner ear structures. Intracochlear schwannomas (ICS) are tumors confined to the cochlea, and these can cause progressive unilateral sensorineural hearing loss, tinnitus, vertigo and aural fullness. Here, we report a 49-year-old female patient with left sudden sensorineural hearing loss. There was no improvement of hearing despite steroid and hyperbaric oxygen therapy. Space occupying lesion in the basal turn of the left cochlea was identified in MRI with enhancement. She underwent tumor removal through an extended round window approach, and cochlear implantation was performed successfully. This is the first case report of cochlear implantation after tumor removal in a patient with ICS in Korea, and we discuss management options with a review of the literature.
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Inflammatory arthritis can affect the auditory system during the disease course. Although most cases show asymptomatic hearing impairment, it can result in hearing loss. Here we describe the case of a 70-year-old female with hearing impairment associated with idiopathic inflammatory arthritis in her auditory system. She had suffered from hearing difficulties for decades; however, the causes of her hearing impairment had not been evaluated. Pure tone audiometry showed severe sensorineural hearing loss requiring a cochlear implant. The workup for the cochlear implant revealed erosive changes in the incudomalleolar and incudostapedial joints with soft tissue swelling on temporal bone computed tomography. Bone pathology revealed plasmacytic infiltration and granulomatous inflammation. Laboratory examinations showed elevated levels of inflammatory markers; otherwise, she had negative results for all autoantibodies. In patients with idiopathic hearing loss, inflammatory arthritis of the middle ear without peripheral arthritis can provide a clue regarding the cause of the hearing loss.
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Objectives@#. This study was conducted to evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy. @*Methods@#. The study included 27 patients (mean age, 58.7 years; age range, 28–76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. The secondary outcome measures were audiological test results and complication rates. @*Results@#. The mean scores for ease of communication (61.3% to 29.7% to 30.2%), reverberation (62.1% to 43.1% to 37.4%), and background noise (63.3% to 37.7% to 34.3%) subscales of the APHAB questionnaire significantly decreased after VSB surgery. The mean K-IOI-HA scores at 3 and 6 months after surgery were significantly higher than the mean preoperative score (18.6 to 27.2 to 28.1). The postoperative VSB-aided thresholds were significantly lower than the preoperative unaided and hearing aid (HA)-aided thresholds. There was no significant difference between preoperative unaided, preoperative HA-aided, and postoperative VSB-aided maximum phonetically balanced word-recognition scores. None of the 27 patients experienced a change in postoperative bone conduction pure tone average. One patient developed temporary facial palsy and two developed surgical wound infections. @*Conclusion@#. RW vibroplasty resulted in improved satisfaction and audiological test results in patients with mixed hearing loss after mastoidectomy, and the complication rate was tolerable.
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BACKGROUNDS@#Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts.@*METHODS@#PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) 30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF 10.0% is not appropriate for all eligible districts.
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Humans , Infant , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Mass Drug Administration , Prevalence , Trachoma/epidemiologyABSTRACT
Background and Objectives@#In this study, we introduce our method of hearing aid (HA) verification using real ear measurement (REM). We verified HAs that have gone through the fitting program using speech mapping REM; we then compared the outcome with word recognition scores (WRS) to evaluate functional gain. Subjects and Method Fifty-six patients of sensorineural hearing loss (81 ears) were enrolled in the study. In REM, if the gap between the target gain of HA and real ear aided response (REAR) was less than 10 dB SPL, fitting was considered successful. In speech audiometry, unaided maximum discrimination score (PB max), unaided WRS at 65 dB HL and aided WRS at 65 dB HL were measured. By comparing PB max and aided WRS at 65 dB HL, patients were sorted into best (n=15), good (n=57), and poorly (n=9) aided groups and analyzed for the successes of fitting. Fitting was deemed unsuccessful if REAR was ≥10 dB SPL lower than the target value of HA. @*Results@#The mean aided WRS at 65 dB HL of best, good and poorly aided groups were 85.6%, 77.3%, and 54.2%, respectively. There were statistically significant differences between all groups (p=0.019, 0.001, 0.002). The success rates of HA fitting showed significant differences at 0.5, 0.75, 1, 4 kHz of 55 dB SPL (p=0.023, 0.005, 0.003, 0.014), and at 4 kHz of 65 and 75 dB SPL (p=0.004, 0.001). The high WRS group showed sufficient gain at many frequencies. @*Conclusion@#Well fitted HAs can provide sufficient increase in speech intelligibility. Using the speech mapping REM is a great method to verify fitting of HA.
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Background and Objectives@#Middle ear implants (MEI) have been reported to be an effective and safe alternative for the treatment of sensorineural hearing loss (SNHL) and conductive hearing loss (CHL). This study aimed to compare the functional outcomes between SNHL and CHL in terms of audiological gains.Subjects and Method The medical records of 14 consecutive SNHL and CHL patients who underwent MEI surgeries from 2015 to 2019 by a single surgeon were retrospectively reviewed. Audiological changes using hearing aids (HA) and MEI were compared. @*Results@#In SNHL, the mean unaided air-conduction pure tone audiometry (PTA), (57.7 dB HL) decreased significantly using HA and MEI (44.7 and 41.4 dB HL), but with no significant difference from each other. Unaided word recognition score (WRS) at 65 dB HL (45.1%) was significantly improved using HA and MEI (72.6% and 76.6%), with no significant difference. In CHL, the mean unaided air-conduction and bone-conduction PTA were 77.1 (57.5-93.8) and 44.1 (26.3-57.5) dB HL. Three patients could not use conventional HAs due to otorrhea and deformity of the external auditory canal by previous surgeries and 4 patients had used conventional HAs before MEI. Though both HA and vibrant soundbridge (VSB) showed improvement of hearing thresholds (32.0 and 48.8 dB HL) and WRS (80.0% and 94.9%), it was significant only when using VSB. There was no significant difference between HA and VSB. @*Conclusion@#MEI can be an effective treatment option for both SNHL and CHL patients, especially for those who suffered from problems using conventional HA.
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Background and Objectives@#There have been no reports in Korea regarding cochlear implant surgeries using Cochlear Nucleus Profile Slim Modiolar electrode [CI532 (Cochlear Ltd.)], as it has been recently released in Korea. We aimed to investigate the short-term results of CI532 and compare them with previous devices with perimodiolar or straight electrodes arrays from the same manufacturer.Subjects and Method From August 2018 to July 2019, 52 patients (26 adults; 26 children) who underwent cochlear implantation of CI532 were included. The intraoperative impedance and evoked compound action potential (ECAP) threshold in each electrode were analyzed and compared with the devices with a perimodiolar electrode array [Contour Advance® (Cochlear Ltd.)] and a lateral wall electrode array [CI422 and CI522 (Cochlear Ltd.)]. Postoperative changes of hearing thresholds at each frequency (250, 500, and 1000 Hz) and aided word recognition scores (WRS) were also compared. @*Results@#CI532 showed significantly lower intraoperative impedance in the basal regions compared to the lateral wall electrode array. The ECAP thresholds of CI532 in the apical electrodes were significantly lower than that in the other two groups. After implantation, CI532 showed a significant preservation of hearing thresholds at most frequencies and showed significantly higher preservation rates than the other electrodes. However, there was no difference between the three groups regarding the postoperative short-term aided WRS. @*Conclusion@#CI532 showed lower intraoperative impedances and ECAP thresholds, and better short-term hearing preservation outcomes compared to the other electrodes, suggesting that CI532 electrode might be a better option with less traumatic insertion. However, there was no significant difference in the aided WRS, and further studies with a longer follow-up are necessary to examine the difference of audiologic outcomes.
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Background and Objectives@#We reviewed the long-term outcomes after tetralogy of Fallot (TOF) repair with trans-annular incision; and evaluated the effectiveness of pulmonary valve replacement (PVR) on outcomes. @*Methods@#This was a retrospective review of clinical outcomes of 180 of 196 TOF patients who underwent total correction with trans-annular incision from 1991 to 1997 (PVR group: 81; non-PVR group: 99). @*Results@#The median age of the patients was 14.0 months (interquartile range [IQR], 10.7–19.8 months) at TOF repair. Ten in-hospital deaths (5.1%) occurred. During the followup, 81 patients underwent PVR at the median age of 13.5 years (IQR, 11.2–17.1 years). The patients in PVR group showed better outcomes than non-PVR group in overall survival rate (100% in PVR vs. 88.7% in non-PVR, p=0.007), in all adverse events (arrhythmia, neurologic complications, 95.5% in PVR vs. 74.6% in non-PVR, p=0.024) at 20 years. Age at TOF repair younger than 1 year (hazard ratio [HR], 2.265; p=0.01) and previous shunt history (HR, 2.195; p=0.008) were predictive for requiring PVR. During follow-up, 10 late deaths (5 sudden deaths) occurred in the non-PVR group, mainly due to ventricular arrhythmia and right ventricular failure; there was 1 late death (not a sudden death) in the PVR group. @*Conclusions@#Long-term survival after repair of TOF with trans-annular incision were acceptable. However, arrhythmias were frequently observed during 20 years of follow-up. The patient age <1 year at the time of TOF repair and shunt implantation prior to TOF repair were predictive factors for requiring PVR.
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Abstract Objective This study sought to compare the biocompatibility of a three-dimensional (3D)-printed titanium implant with a conventional machined titanium product, as well as the effect of such implant applied with recombinant human Bone Morphogenetic Protein Type 2 (rhBMP-2) for guided bone regeneration. Methodology Disk-shaped titanium specimens fabricated either by the conventional machining technique or by the 3D-printing technique were compared by MC3T3-E1 cells cytotoxicity assay. New bone formation was evaluated using a rapid prototype titanium cap applied to the calvaria of 10 rabbits, which were divided into two groups: one including an atelopeptide collagen plug on one side of the cap (group I) and the other including a plug with rhBMP-2 on the other side (group II). At six and 12 weeks after euthanasia, rabbits calvaria underwent morphometric analysis through radiological and histological examination. Results Through the cytotoxicity assay, we identified a significantly higher number of MC3T3-E1 cells in the 3D-printed specimen when compared to the machined specimen after 48 hours of culture. Moreover, morphometric analysis indicated significantly greater bone formation at week 12 on the side where rhBMP-2 was applied when evaluating the upper portion immediately below the cap. Conclusion The results suggest that 3D-printed titanium implant applied with rhBMP-2 enables new bone formation.
Subject(s)
Animals , Osteogenesis , Titanium , Rabbits , Skull/surgery , Bone Regeneration , Recombinant Proteins , Transforming Growth Factor beta , Bone Morphogenetic Protein 2 , Printing, Three-DimensionalABSTRACT
Background and Objectives@#We reviewed the long-term outcomes after tetralogy of Fallot (TOF) repair with trans-annular incision; and evaluated the effectiveness of pulmonary valve replacement (PVR) on outcomes. @*Methods@#This was a retrospective review of clinical outcomes of 180 of 196 TOF patients who underwent total correction with trans-annular incision from 1991 to 1997 (PVR group: 81; non-PVR group: 99). @*Results@#The median age of the patients was 14.0 months (interquartile range [IQR], 10.7–19.8 months) at TOF repair. Ten in-hospital deaths (5.1%) occurred. During the followup, 81 patients underwent PVR at the median age of 13.5 years (IQR, 11.2–17.1 years). The patients in PVR group showed better outcomes than non-PVR group in overall survival rate (100% in PVR vs. 88.7% in non-PVR, p=0.007), in all adverse events (arrhythmia, neurologic complications, 95.5% in PVR vs. 74.6% in non-PVR, p=0.024) at 20 years. Age at TOF repair younger than 1 year (hazard ratio [HR], 2.265; p=0.01) and previous shunt history (HR, 2.195; p=0.008) were predictive for requiring PVR. During follow-up, 10 late deaths (5 sudden deaths) occurred in the non-PVR group, mainly due to ventricular arrhythmia and right ventricular failure; there was 1 late death (not a sudden death) in the PVR group. @*Conclusions@#Long-term survival after repair of TOF with trans-annular incision were acceptable. However, arrhythmias were frequently observed during 20 years of follow-up. The patient age <1 year at the time of TOF repair and shunt implantation prior to TOF repair were predictive factors for requiring PVR.
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ObjectiveTo evaluate the effect of the integrated echinococcosis control program in Ningxia Hui Autonomous Region from 2011 to 2018. MethodsA package of integrated interventions were employed for echinococcosis control in 22 counties (districts) of Ningxia Hui Autonomous Region from 2011 to 2018, including screening of human echinococcosis, treatment of echinococcosis patients, deworming of domestic dogs and monitoring of infections, surveillance of echinococcosis in bovines and sheep, health education. The detection of human echinococcosis, seroprevalence of anti-Echinococcus antibody in children at ages of 6 to 12 years, the Echinococcus coproantigen-positive rate in domestic dogs, prevalence of echinococcosis in bovines and sheep, and the awareness of echinococcosis control knowledge were investigated and compared during the period between 2011 and 2018. Results The detection of human echinococcosis appeared a decline tendency in Ningxia Hui Autonomous Region over years during the period from 2011 to 2018 (χ2trend = 82.22, P < 0.05), and the prevalence of human echinococcosis decreased from 0.31% in 2011 to 0.15% in 2018. The seroprevalence of anti-Echinococcus antibody appeared a decline tendency in children at ages of 6 to 12 years over years (χ2trend = 439.64, P < 0.01), and the prevalence of anti-Echinococcus antibody decreased from 6.12% in 2011 to 0.67% in 2018. The Echinococcus coproantigen-positive rate appeared a decline tendency in domestic dogs over years (χ2trend = 260.33, P < 0.05), and the prevalence of anti-Echinococcus antibody decreased from 7.11% in 2011 to 0.75% in 2018. The prevalence of bovine and sheep echinococcosis reduced from 3.26% and 5.08% in 2011 to 1.35% and 0.76% in 2018, and Echinococcus predominantly parasitized in bovine (92.00%) and sheep (93.94%) livers. A total of 63 stool samples were collected from red fox, wolf and badger in Xiji and Haiyuan counties of Ningxia Hui Autonomous Region in 2013 and 2014, with no Echinococcus coproantigen-positives detected, and 107 domestic cats and 3 domestic dogs were dissected in these two counties, with no Echinococcus found. A total of 6 046 wild mice were dissected in Xiji County, Yuanzhou District and Haiyuan County of Ningxia Hui Autonomous Region from 2016 to 2019, and the prevalence of E. multilocularis was 0.31%. The awareness of echinococcosis control knowledge appeared an increasing tendency in Ningxia Hui Autonomous Region over years from 2011 to 2018 (χ2trend = 3 367.97, P < 0.01), and the awareness increased from 21.83% in 2011 to 72.24% in 2018. Conclusions The integrated echinococcosis control program achieves a remarkable effect in Ningxia Hui Autonomous Region, and the transmission of echinococcosis has been preliminarily controlled. However, the echinococcosis transmission risk remains in few regions, and the integrated echinococcosis control program remains to be reinforced.
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Supravalvar aortic stenosis (SVAS) is a rare congenital cardiac disease that usually co-occurs with Williams syndrome. In the adult population, a few SVAS cases have been reported in patients affected by homozygous familial hypercholesterolemia. However, because of the rarity of this disease entity, there is no standard surgical treatment for SVAS. Here, we present a case of successful surgical treatment using an autologous excised aortic patch in a 65-year-old patient with SVAS.
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Background and Objectives@#This study presents an update of the surgical outcomes ofcongenital heart disease (CHD) according to Korea Heart Foundation (KHF) data. @*Methods@#We investigated the data of the 7,305 patients who were economically supportedby KHF in 2000–2014. Of them, we analyzed surgical outcomes of the 6,599 patients whounderwent CHD surgery. @*Results@#The median patient age was 1.9 years (range, 0–71.5 years). Of the 6,599 patients,5,616 (85.1%) underwent biventricular repair and 983 (14.9%) underwent palliativeprocedures. The mean Basic Aristotle Score was 6.6±2.2. A complex procedure (definedas Basic Aristotle Score above 6) was performed in 3,368 patients (51.0%). The earlymortality rate was 3.8%, while the late mortality rate was 1.8%. Previous reports of the KHF(1984–1999) showed that the early surgical and late mortality rates were 8.6%, and 5.3%,respectively. There were 491 neonates (7.4%); among them, the early mortality rate was 12.2%and late mortality rate was 3.7%. There were 2,617 infants (40.0%); among them, the earlymortality rate was 6.0% and the late mortality rate was 2.3%. A total of 591 patients from 30countries were helped by the KHF. @*Conclusions@#More neonatal surgeries (491 vs. 74 patients) were performed than those inthe past (1984–1999). The surgical outcomes were much better than before. Our surgicaloutcomes revealed that the Republic of Korea has been transformed from a country receivinghelp to a country that helps other low socioeconomic status countries.
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Objectives@#. Cortical auditory evoked potentials (CAEPs) have been used to examine auditory cortical development or changes in patients with hearing loss. However, there have been no studies analyzing CAEP responses to the different sound stimulation by different stimulation sides. We characterized changes in normal CAEP responses by stimulation sides in normal-hearing adults. @*Methods@#. CAEPs from the right auditory cortex were recorded in 16 adults following unilateral (ipsilateral and contralateral) and bilateral sound stimulation using three speech sounds (/m/, /g/, and /t/). Amplitudes and latencies of the CAEP peaks in three conditions were compared. @*Results@#. Contralateral stimulation elicited larger P2-N1 amplitudes (sum of P2 and N1 amplitudes) than ipsilateral stimulation regardless of the stimulation sounds, mostly due to the larger P2 amplitudes obtained, but elicited comparable P2-N1 amplitudes to bilateral stimulation. Although the P2-N1 amplitudes obtained with the three speech sounds were comparable following contralateral stimulation, the /m/ sound elicited the largest P2-N1 amplitude in ipsilateral stimulation condition due to the largest N1 amplitude obtained, whereas /t/ elicited larger a P2-N1 amplitude than/g/ in bilateral stimulation condition due to a larger P2 amplitude. @*Conclusion@#. Spectrally different speech sounds and input sides are encoded differently at the cortical level in normal-hearing adults. Standardized speech stimuli, as well as specific input sides of speech, are needed to examine normal development or rehabilitation-related changes of the auditory cortex in the future.